Medicaid Patients Go to Emergency Room More Often

March 22, 2012

Looking to data collected by the U.S. National Health Interview Survey between 1999 and 2009, researchers have found two standout trends among Medicaid beneficiaries: they have more difficulty getting primary care and they visit hospital emergency departments more often than those with private insurance, says U.S. News & World Report.

Medicaid patients face significantly greater barriers to primary care, including not being able to reach a doctor by phone, not being able to get a timely appointment with a doctor and lack of transportation to the doctor's office.

Researchers found that about 16 percent of Medicaid beneficiaries faced one or more such barriers to primary care.

This proportion is significantly greater than the 9 percent of those with private insurance who have the same problem.

This lack of primary access contributes in part, but certainly not in whole, to greater frequency of visits to hospital emergency departments.

The researchers found that nearly 40 percent of Medicaid patients visited a hospital emergency department during the previous year.

This figure is more than twice the portion of private insurance patients who did the same (18 percent).

Dr. Adit Ginde, of the University of Colorado School of Medicine, says that the poor access to primary care only explains a portion of the higher rate of emergency room visitation. He points to an overall lower health quality among Medicaid patients as another factor.

Among patients with two or more barriers to primary care, 61 percent of Medicaid patients visited a hospital emergency department during the previous year.

Thus, it is likely that a number of other factors besides these barriers contribute to the greater need for emergency care.

Dr. David Seaberg, president of the American College of Emergency Physicians, emphasizes that as states attempt to reduce emergency care utilization among Medicaid patients, a thorough understanding of these contributing factors will be essential for good policy.